I'd appreciate advice on this surgical scenario. A physician removes 2 nephrostomy tubes ( right, upper and a lower poles) and right ureteral stent and performs nephrostograms, and removes 8 stone frgments. He then places two nephrostomy tubes back in the upper and lower right kidney.

Eventhough it is on the same side(right) would you code each nephrostomy w/ stone removal 2x along with 2 nephrsotomy tube changes becasue it is in the upper and lower pole (separate acess sites)?

50561-RT, 59 (2nd neprostomy calculus removal)
50398-RT, 59 (2nd nephrostomy tube change)
50384-RT (percutaneous ureteral stent removal)

Advice would be greatly appreciated.

Thank you.